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SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE INC NPI 1881661874


NPI Information

NPI: 1881661874
Provider Name: SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC

Doing Business As: NEW AUGUSTA FAMILY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 25D0858902

Address:
404 MAIN STREET
NEW AUGUSTA, MS
ZIP 39462
Phone: (601) 964-8391
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SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC is a federally qualified health center (fqhc) clinic center in New Augusta, MS. SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC NPI is 1881661874. The provider is registered as an organization entity type.
The provider Is Doing Business As New Augusta Family Health Center.

The provider's business location address is:

404 MAIN STREET
NEW AUGUSTA, MS
ZIP 39462-000
Phone: (601) 964-8391
Fax: (601) 964-8398

The provider's authorized official is Kaye Ray .
The authorized official title is Executive Director and has the following contact phone number (601) 545-8700.

The CLIA number assigned to this NPI record is 25D0858902 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/8/2006 and was last updated on 9/6/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
109013878MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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